Harnessing the power of language to enhance patient experience of the NHS complaint journey in Northern Ireland: a mixed-methods study.

Background: Good communication is consistently recognised as essential for effective complaint handling, while failures in communication correlate with risk of escalation. Nonetheless, communication in National Health Service complaint handling remains underexamined.

Objectives: To examine complainants' lived experience of the complaints journey through (1) micro-analysis of their communication with National Health Service representatives; (2) their self-reported expectations and experiences throughout the complaints journey; to survey patient perceptions of the culture of the National Health Service; to develop 'Real Complaints' - an evidence-based communication training resource.

Why affiliation matters: A conversation analysis of complaints calls to the NHS.

Objective: Callers making a complaint share their negative experience in complaint narratives that make relevant affiliation from an operator. We examined how call handlers' language choices affect both the progress of the call and the stance of the caller.

Methods: We identified episodes where affiliation is displayed or noticeably absent in a dataset of 95 complaints calls to the NHS.

Negotiating relevance in pre-operative assessments.

Preoperative assessments provide an essential clinical risk assessment aimed at identifying patient risks and requirements prior to surgery. As such they require effective and sensitive information-gathering skills. In addition to physical examination, the preoperative assessment includes a series of routine questions assessing a patient's fitness for surgery.

Adaptation to aphasia: grammar, prosody and interaction.

This paper investigates recurrent use of the phrase very good by a speaker with non-fluent agrammatic aphasia. Informal observation of the speaker's interaction reveals that she appears to be an effective conversational partner despite very severe word retrieval difficulties that result in extensive reliance on variants of the phrase very good. The question that this paper addresses using an essentially conversation analytic framework is: What is the speaker achieving through these variants of very good and what are the linguistic and interactional resources that she draws on to achieve these communicative effects? Tokens of very good in the corpus were first analyzed in a bottom-up fashion, attending to sequential position, structure and participant orientation.

Gaze and the turn: a nonverbal solution to an interactive problem.

This paper examines the use of gaze as one of a number of connected compensatory adaptations to linguistic impairment by a patient with Broca's aphasia. The examination of the import of gaze withdrawal and return of gaze in the context of self cuing by the patient shows how the patient exploits the complex multifaceted nature of meaning making. Consonant with the concept of emergentist pragmatics (Perkins), meaning making is shown to be a distributed process with sufficient "plasticity" to allow the aphasic patient to compensate for their linguistic impairments yet still be sensitive to the interactive needs of their interlocutor.